Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 7

Efficacy of indacaterol 75 µg versus fixed-dose combinations of formoterol-budesonide or salmeterol-fluticasone for COPD: a network meta-analysis

Authors Cope S, Kraemer M, Zhang J, Capkun-Niggli G, Jansen JP

Received 6 March 2012

Accepted for publication 2 May 2012

Published 5 July 2012 Volume 2012:7 Pages 415—420

DOI https://doi.org/10.2147/COPD.S31526

Review by Single-blind

Peer reviewer comments 2


Shannon Cope,1 Matthias Kraemer,2 Jie Zhang,3 Gorana Capkun-Niggli,2 Jeroen P Jansen1

1MAPI Consultancy, Boston, MA, USA; 2Novartis Pharmaceuticals, Basel, Switzerland; 3Novartis Pharmaceuticals, East Hanover, NJ, USA

Background: The purpose of this study was to update our network meta-analysis in order to compare the efficacy of indacaterol 75 µg with that of a fixed-dose combination of formoterol and budesonide (FOR/BUD) and a fixed-dose combination salmeterol and fluticasone (SAL/FP) for the treatment of chronic obstructive pulmonary disease (COPD) based on evidence identified previously in addition to two new randomized clinical trials.
Methods: Fifteen randomized, placebo-controlled clinical trials including COPD patients were evaluated: indacaterol 75 µg once daily (n = 2 studies), indacaterol 150 µg once daily (n = 5), indacaterol 300 µg once daily (n = 4), FOR/BUD 9/160 µg twice daily (n = 2), FOR/BUD 9/320 µg twice daily (n = 2), SAL/FP 50/500 µg twice daily (n = 4), and SAL/FP 50/250 µg twice daily (n = 1). All trials were analyzed simultaneously using a Bayesian network meta-analysis and relative treatment effects between all regimens were obtained. Treatment-by-covariate interactions were included where possible to improve the similarity of the trials. Outcomes of interest were trough forced expiratory volume in 1 second (FEV1) and transitional dyspnea index at 12 weeks.
Results: Based on the results without adjustment for covariates, indacaterol 75 µg resulted in a greater improvement in FEV1 at 12 weeks compared with FOR/BUD 9/160 µg (difference in change from baseline 0.09 L [95% credible interval 0.04–0.13]) and FOR/BUD 9/320 µg (0.07 L [0.03–0.11]) and was comparable with SAL/FP 50/250 µg (0.00 L [-0.07–0.07]) and SAL/FP 50/500 µg (0.01 L [-0.04–0.05]). For transitional dyspnea index, data was available only for indacaterol 75 µg versus SAL/FP 50/500 µg (-0.49 points [-1.87–0.89]).
Conclusion: Based on results of a network meta-analysis with and without covariates, indacaterol 75 µg is expected to be at least as efficacious as FOR/BUD (9/320 µg and 9/160 µg) and comparable with SAL/FP (50/250 µg and 50/500 µg) in terms of lung function. In terms of breathlessness (transitional dyspnea index) at 12 weeks, the results are inconclusive given the limited data.

Keywords: chronic obstructive pulmonary disorder, COPD, network meta-analysis, indacaterol

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]